The initial focus of the San Diego Center for Education and Research in Patient Safety (SDCERPS) will be to develop, apply, and evaluate the "Standardized Encounter" for the study of medical error. SDCERPS will build a multi-disciplinary team that, in collaboration with UCSD Healthcare, the VA San Diego Healthcare System, a network of community physicians, will create a research a research and education infrastructure to address critical patient safety tissues. A standardized encounter is a controlled reproducible simulated interaction between clinical provider(s) and a patient (or patient data) or another clinician. Standardized encounters may include the use of realistic or virtual stimulators, standardized patients, or standardized telephone or computer interactions. It is hypothesized that the standardized encounter is an effective strategy for the study of patient safety, complementary to other research techniques. The proposal's Specific Aims are: 1) To create a multi-disciplinary team and infrastructure to address patient safety issues, primarily at the level of clinician-patient interaction; 2) team and infrastructure to address patient safety issues, primarily at the level of clinician-patient interaction; 2) To evaluate the standardized encounter as a valid and useful patient safety tool; 3) To begin to develop Patient Safety Laboratories encompassing both real and simulated care environments; 4) To examine specific safety issues in which the proposed methodologies will yield valuable results; and 5) To create training aids, curricula, and other materials to disseminate the research tools and patient safety knowledge gained through these efforts. Actual clinical settings will become "virtual laboratories" that, along with simulation laboratories,, will permit the study of how Standardized Encounter Techniques can be best applied across a spectrum of specialities and teams, care settings, and patient populations. Although this approach has widespread application, SDCERPS will initially focus on two areas: 1) the role of clinical experience in the occurrence of, and recovery from, medical error; and 2) the role of interpersonal communication in patient safety. The proposed pilot study will begin to examine the feasibility, validity, reliability, and limitations of standardized encounters in patient safety research and education. The results will promote the study of medical error, safety training, and evaluation of the success of safety interventions across the medical domain.